Federal auditors found 182 instances of noncompliance at North Dakota residential habilitation settings for Medicaid waiver participants with intellectual and developmental disabilities. The HHS Office of Inspector General issued the audit of the state's oversight on June 16, 2026, and posted it June 18.
What the auditors found
Auditors reviewed 16 providers and 51 residential settings and found 182 instances of noncompliance. Eight providers had 108 administrative problems, including incomplete or late background checks on staff. At 44 settings, auditors found 74 health, safety or records problems, such as late fire extinguisher inspections, missing or broken smoke detectors, expired food, exposed wiring, mold and medications that were not properly controlled. One provider could not show a written infection control policy. Some providers cited staffing shortages and leadership changes. OIG recommended that the state follow up on every finding, strengthen monitoring and help providers improve internal controls, records and training. North Dakota agreed with two recommendations and disagreed with one.
Why this matters for providers and DSPs
OIG runs these audits in state after state, and the findings are the kind of everyday lapses DSPs can catch. Routine home safety checks and complete staff files are the best preparation.